NPIMap

Organization Active NPI

Clark Chiropractic Clinic

  • Chiropractor
  • Renton, WA
National Provider Identifier
1447798830
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MA00005302 Issued in WA
Legal business name
CLARK CHIROPRACTIC CLINIC
Practice address
17422 108TH Ave SE
Renton, WA 98055-5400
Phone
(425) 255-0427
Fax
(425) 255-1066
NPI assigned
Feb 6, 2017
Last updated
Feb 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Chris Watson
Title
Office Manager
Phone
(425) 255-0427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X MA00005302 WA Primary

Addresses

Primary practice location

17422 108TH Ave SE
Renton, WA 98055-5400

Mailing address

17422 108TH Ave SE
Renton, WA 98055-5400
Phone (425) 255-0427

National Provider Directory

National Provider Directory
Tax ID family
Clark Chiropractic Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

17422 108th Ave SE
Renton, WA 98055
Phone (425) 255-0427

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486339200000",
    "number": "1447798830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17422 108TH AVE SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555400",
            "telephone_number": "425-255-0427",
            "fax_number": "425-255-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17422 108TH AVE SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555400",
            "telephone_number": "425-255-0427",
            "fax_number": "425-255-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-255-0427",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "MA00005302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.